P02-14 KaziBantu ‘healthy schools for healthy communities' - A holistic approach to enhance health literacy and physical activity in primary schools from low-resourced settings in South Africa

Abstract Backgound The disease profile of low- to middle-income countries is moving towards one seen in Westernised countries, where deaths are mainly attributed to chronic diseases. Children develop risk factors at a young age predisposing them to noncommunicable diseases in adulthood. Most of the risk factors are preventable through healthy lifestyles. Results from South Africa (SA) show that many children, particularly from marginalized communities, do not achieve the minimal requirements of physical activity (PA). Thus, more emphasis needs to be placed on primary prevention strategies, such as incorporating health promotion interventions within established educational and workplace structures. Primary schools present unique opportunities for holistic prevention interventions. Methods Using an ecosystem approach, an interprofessional team of PA researchers, public health specialists and digital innovators, together with partners from the ministry of education and ministry of health in SA, was set up to map and tackle the role of physical education (PE) in the SA school system. Experts identified actionable changes at the school, teacher and policy levels. First, a comprehensive health intervention was developed and implemented in primary schools in low resourced settings in the Eastern Cape of SA. The intervention was followed to learn and adapt. Finally, changes in the educational system will be scaled-up and sustained through governmental institutionalization. Results In 1994 PE lost its stand-alone subject status and became part of Life Orientation. Ever since, non-specialist teachers lack the confidence and understanding to adequately teach the subject. The interdisciplinary team developed ‘the KaziBantu model (Healthy Schools for Healthy Communities)’, to promote PA and healthy lifestyles in public primary schools through two complementary programs: KaziKidz, a PE toolkit for schoolchildren, and KaziHealth, a workplace health intervention program for teachers. Furthermore, Short Learning Programs have been developed for continued professional development of life orientation teachers, thereby introducing lasting changes within the educational system. Discussion/Conclusion PE and health literacy are oftentimes neglected in the SA curriculum, especially in marginalized areas. System-wide changes initiated and sustained through local ownership are critical to ensure long-lasting impact. Our multilateral intervention aimed to achieve this to offer children and teachers a quality education.


Backgound
The disease profile of low-to middle-income countries is moving towards one seen in Westernised countries, where deaths are mainly attributed to chronic diseases. Children develop risk factors at a young age predisposing them to noncommunicable diseases in adulthood. Most of the risk factors are preventable through healthy lifestyles. Results from South Africa (SA) show that many children, particularly from marginalized communities, do not achieve the minimal requirements of physical activity (PA). Thus, more emphasis needs to be placed on primary prevention strategies, such as incorporating health promotion interventions within established educational and workplace structures. Primary schools present unique opportunities for holistic prevention interventions. Methods Using an ecosystem approach, an interprofessional team of PA researchers, public health specialists and digital innovators, together with partners from the ministry of education and ministry of health in SA, was set up to map and tackle the role of physical education (PE) in the SA school system. Experts identified actionable changes at the school, teacher and policy levels. First, a comprehensive health intervention was developed and implemented in primary schools in low resourced settings in the Eastern Cape of SA. The intervention was followed to learn and adapt. Finally, changes in the educational system will be scaled-up and sustained through governmental institutionalization.

Results
In 1994 PE lost its stand-alone subject status and became part of Life Orientation. Ever since, non-specialist teachers lack the confidence and understanding to adequately teach the subject. The interdisciplinary team developed 'the KaziBantu model (Healthy Schools for Healthy Communities)', to promote PA and healthy lifestyles in public primary schools through two complementary programs: KaziKidz, a PE toolkit for schoolchildren, and KaziHealth, a workplace health intervention program for teachers. Furthermore, Short Learning Programs have been developed for continued professional development of life orientation teachers, thereby introducing lasting changes within the educational system. Discussion/Conclusion PE and health literacy are oftentimes neglected in the SA curriculum, especially in marginalized areas. System-wide changes initiated and sustained through local ownership are critical to ensure long-lasting impact. Our multilateral intervention aimed to achieve this to offer children and teachers a quality education. Keywords: Quality physical education, health promoting intervention, public primary schools, governmental institutionalization, disadvantaged settings, South Africa Abstract citation ID: ckac095.034 P02-15 Green exercise for well-being: an exploration of psychological responses to physical activity in outdoor and indoor environments Laura Scott 1 1 Fü rth, Germany Corresponding author: lscott7@protonmail.com

Background
There is an emerging body of knowledge regarding beneEts of outdoor activity on well-being, restoration and mood enhancement. This pre-post study explored psychological outcomes in groups carrying out exercise classes in outdoor and indoor settings. An aim looks to environment in group classes for physical activity programs for population health. Research Questions: (1) What are the psychological outcomes after a green exercise session (2) Is there a difference in psychological scores between indoor and outdoor exercise programs? Methods Two groups of subjects undertaking similar exercises for one hour, in two settings: a Etness studio (N = 19) and a city park (N = 15), subjects completed the Subjective Exercise Experience Scale (SEES) prior to and post classes. Paired t-tests for dependent groups identiEed differences in the three categories of SEES, computed by IMB SPSS Statistics 20.

Results
Exercise in each group improved scores of psychological wellbeing.
Independent samples t-test showed the outdoor group reported higher psychological well-being markers in the presurvey. Statistically signiEcant difference for ''awful'' with indoor (M = 2.8421, SD=1.64192) and outdoor (M = 1.7333, SD=.96115); conditions t(32)=2.32, p=.027. Paired samples ttest showed weak statistical signiEcance for improved values for psychological well-being (M = 5.36, SD=1.24) and decreased values for psychological distress (M = 1.08, SD=1.87) in the indoor group pre to post. There were no statistically signiEcant differences between pre and post survey data, the outdoor environment did not garner higher response scores than the indoor group. Limitations included relatively small sample size, difference in age between outdoor and studio participants, as well as a hot summer in Germany, which may have impacted the perceived well-being scores.

Conclusions
Exercise is beneEcial to psychological well-being, regardless of environment. The study did not provide evidence that green exercises elicited greater psychological responses, likely due to study limitations. The outdoor cohort, 50-70 years of age, demonstrated a heightened interest in outdoor programs. Indoor exercise classes should be encouraged as it decreases distress. Green exercise could foster anticipation of a more positive experience yet weather could impact mood outcomes. Intensity, hydration and shade should be prioritized. green exercise studies should include objective measures such as Abstract citation ID: ckac095.035 P02-16 Implementation of a program based on adapted physical activity and recommendations for second cancers prevention for adolescents and young adults with cancer: PREVAPAJA study Background/Objectives About 1,000,000 new cases of cancer in Adolescent and Young Adults (AYAs) are diagnosed annually worldwide. . While their long term survival is about 80%, they are six times more likely to develop a second primary cancer (SPC) compared to their peers. This risk is multifactorial and depends on the type of first cancer, treatment received and prevalence of risk factors. PREVAPAJA aimed to implement a clinical program based on physical activity (PA) and cancer prevention recommendations for AYAs with cancer at Centre Léon Bérard-AYAs Department.

Methods
The study was conducted at Leon Berard Comprehensive Cancer Centre among patients aged 15-25 years. AYAs attended PA sessions during the active treatment period and were individually informed on SPC risk prevention. PA, sedentary, anthropometrics, quality of life and fatigue were assessed at baseline (T1) and at the end of treatment (T2). PA level and intention of changes in health behaviors were assessed by phone 1 year after T1. Results 68 AYAs (median age=19 years) were enrolled in 2016-2017). The results showed an improvement in PA level during and at distance of the intervention, with also a reduction of sitting time. Fatigue decreased between T1 and T2 (p>0.003) and overall quality of life improved significantly between T1 and T2 (p>0.001).